Anal fissure

Causes

What causes anal fissures?

Anal fissures are most commonly caused by damage to the lining of the anus or anal canal.

Most cases occur in people who have constipation, when a particularly hard or large stool tears the lining of the anal canal.

Other possible causes of anal fissures include:

persistent diarrhoea
inflammatory bowel disease (IBD), such as Crohn's disease and ulcerative colitis
pregnancy and childbirth
occasionally, a sexually transmitted infection (STI), such as syphilis or herpes , which can infect and damage the anal canal
having unusually tight anal sphincter muscles, which can increase the tension in your anal canal, making it more susceptible to tearing

In many cases, no clear cause can be identified.

Who is at risk for an anal fissure?

Anal fissures are common during infancy. Older adults are also prone to anal fissures due to decreased blood flow in the anorectal area. During and after childbirth, women are at risk for anal fissures due to straining during delivery.

People with IBD, such as Crohn’s disease, also have a higher risk of developing anal fissures. The inflammation that occurs in the intestinal lining makes the tissue around the anus more prone to tearing. People who frequently experience constipation are at an increased risk for anal fissures as well. Straining and passing large, hard stools are the most common causes of anal fissures.

Medically Reviewed by a doctor on 14 Jan 2018
Medical Author: Dr. med. Diana Hysi

Articles for anal fissure

Introduction

An anal fissure is a small lesion in the lining of the anal canal. The crack in the skin causes severe pain and some bright red bleeding during and after bowel movements.

Symptoms

Symptoms of an anal fissure are pain during defecation which is accompanied with a deep, severe pain which lasts for several hours, bleeding during defecation, etc. It is recommended to see a physician after experiencing the aforementioned symptoms.

Treating anal fissures

Symptoms of anal fissures may pass without specific treatment. They can however return if patients to not undertake measures to prevent them, especially in trying to prevent constipation from occurring. In some patients, symptoms may last for six weeks or more (chronic fissure).

Causes

The most common cause for a fissure is frequent constipation. A few people experience defecating large and rigid feces which may damage the anal canal upon exit. Other causes include: Chronic diarrhea, ulcerative colitis, giving birth, pregnancy, sexually transmissible diseases, etc.

Diagnosis

A doctor will take a thorough history of your symptoms and their characteristics. The doctor may perform a rectal exam, during which they may observe the patient blood and pain upon pressure.

Prevention

Anal fissures usually heal within a few weeks without the need for treatment. However, they can easily recur if they're caused by constipation that remains untreated. Adopting some simple self-help measures can make passing stools easier. This will allow existing fissures to heal.

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